Nursing home of last resort on the verge of being closed

But now the nonprofit Farren Care Center appears on the verge of being closed and its patients steered to a Holyoke nursing home that is being sold to a for-profit Connecticut health care corporation.

The proposal, decried by some health workers and advocates, would force Farren residents to be transferred in the middle of a pandemic, with nearly all of them moving to the Mount Saint Vincent Care Center, a facility where 13 residents died of coronavirus earlier this year.

No coronavirus deaths or any positive COVID cases have been reported at Farren, located in a small Western Massachusetts town with an average case rate of 0.8 per 100,000 people over the two weeks ending Oct. 14, according to state data. In Holyoke, that figure was 13, which places the city in a high-risk category.

“It’s beyond my comprehension as to why they’re doing it while we have COVID happening,” said Judi Fonsh, who worked as Farren’s social services and admissions director during 20 years at the facility before retiring in 2017.

“The Farren mission, its values, and culture have really provided the care that has been so important for these people,” she said. “There is no way they can do that after the transfer.”

Officials at iCare Health Network, Farren’s prospective owner, said the company is well-suited to continue a tradition of specialized individual treatment. Clients from the Farren, located 30 miles north of Holyoke, are treated under an arrangement that offers higher reimbursement rates than generic nursing homes receive.

“We are known problem solvers. We have management leadership and staff that are in the trenches,” said David Skoczulek, vice president of business development for iCare. “We have really good outcomes. We want to continue this mission.”

The company operates behavioral health nursing units at six locations in Connecticut and has been managing Farren since January. Closing the Farren is subject to approval by the state Department of Public Health, which has been reviewing the proposal.

Farren opened as a psychiatric nursing home in 1990, about two years after the closure of a hospital at the same site that was owned by the Sisters of Providence. At the time, the state Department of Mental Health said the center was needed for mentally ill residents with severe health problems, who had been scattered at facilities across the state.

The state provided a loan to help pay for startup costs. A series of mergers and acquisitions eventually put the 122-bed facility in the hands of Trinity Health of New England Senior Communities, a nonprofit group of Catholic rest homes, nursing homes, and rehabilitation programs.

In August, a plan was announced by iCare, Trinity Health, and the Sisters of Providence Ministry Corp. to close Farren and offer beds to its residents at Mount Saint Vincent. Without the deal, both facilities would likely close, the state said.

Nursing home residents at Mount Saint Vincent, established in 1971 by the Sisters of Providence, are not required to have dual diagnoses and do not present as many treatment challenges, advocates and family members said.

They also are predominantly in their 80s and 90s, as much as 30 years older than many Farren clientele who would transfer there. Under a separate plan being considered by state public health officials, iCare would assume control of the 125-bed Mount Saint Vincent, which state officials said is operating at 50 percent capacity and has been on the verge of closing for months.

In budget projections filed with the state, iCare estimated that 10 Mount Saint Vincent residents would remain at that facility, with the rest going to other nursing homes. The company also projected that 92 Farren residents would be transferred to Holyoke within the first four months of operation.

Christine Looby, a spokeswoman for Trinity Health, said residents at Farren, which has a proposed closing date of Dec. 31, are not obligated to relocate to Mount Saint Vincent.

Despite iCare’s assurances, family members and advocates worry that the Holyoke facility will be unable to provide Farren residents with the intensive care they need. They also worry about the health dangers of moving compromised clients during a pandemic.

“It’s nuts, it’s crazy, it’s dangerous,” said Doris Bardwell, a retired registered nurse from South Deerfield whose 94-year-old mother is at Mount Saint Vincent’s. “I don’t understand why it’s being done now. No one else in the state has been allowed to do anything in a normal way — weddings, funerals, graduations, you name it.

“If you look at the pros and cons of doing this, what are the pros? It’s just money,” added Bardwell, who has worked with neurologically impaired patients in an acute-care facility and as a catastrophic case manager.

Bardwell, whose mother has Alzheimer’s disease, wrote in protest to Governor Charlie Baker last month.

“This is not the right time. This can wait until family can resume normal entry into facilities and be a part of the process of transition,” she wrote. “Imagine if it was happening to your loved one?”

Bardwell also questioned how the numbers add up, because Mount Saint Vincent is more than 30 beds short of accommodating every Farren client if they transfer there. As of Thursday, 58 of the 125 beds at Mount Saint Vincent were being used, according to Trinity Health.

“Most of the people at Mount Saint Vincent are in their mid-90s, so of course their days are numbered,” Bardwell said. “They’re going to get more money for each Farren patient.”

On Aug. 17, she said, Trinity delivered letters to the bedsides of Mount Saint Vincent residents and called staff together to announce that the facility would be sold. Bardwell, who is her mother’s health-care proxy, said she received nothing in the mail.

“Information has not been disseminated properly and in a timely way,” Bardwell said. “My mother was starting to pack her things and take them out of her drawer. She told us she was waiting for us to pick her up because everyone was leaving.”

Caring for the different needs of Farren and Mount Saint Vincent’s residents is likely to prove challenging, specialists said.

Dr. Stephen Bartels, a professor of medicine and director of the Mongan Institute at Massachusetts General Hospital, said finding skilled nursing care for residents with mental illness or developmental disabilities is a systemic problem.

“There’s not enough of these specialty units,” Bartels said. “It’s a national need.”

Psychiatric residents who need skilled nursing care generally do not thrive in long-term facilities that do not specialize in mental illness, even if the facilities offer programs for people with cognitive disorders such as dementia and Alzheimer’s disease, Bartels said.

“The treatments and the management are just different for those things,” Bartels said. “They may not get the kind of stabilizing and interactive, group-based care and treatments that can be most helpful to them.”

Elizabeth DeLiso of Northfield, whose husband Joseph had dementia and died Sept. 24 at Farren, said she had made arrangements before his death to move him to another facility because of her concerns about staffing following the closing announcement.

“I had a feeling that the way the closure was being handled, it was inevitable that the care would deteriorate simply because they were going to lose staff very quickly,” DeLiso said.

While Skoczulek said iCare is waiting to hear how many Mount Saint Vincent residents plan to stay before finalizing an operating plan, the president of the Sisters of Providence said the nursing home will eventually be devoted exclusively to treating residents who would have been admitted to Farren.

“While we’re saddened by this, we can continue this quality care,” Sister Kathleen Popko said. “It will be sustained at this site.”

Keeping the program at Farren, she said, was impossible given the condition of the century-old building. A plan to inject $30 million into the facility from a state bond bill passed in 2018 never materialized.

In addition, Popko said that finding qualified workers in the Montague area to treat psychiatric residents who also need 24-hour nursing care was too difficult.

“This is a very painful transition for everybody,” she said.

Brian MacQuarrie can be reached at [email protected] Laura Crimaldi can be reached at [email protected] Follow her on Twitter @lauracrimaldi.

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